评价烧伤中的第一种积极培养:重新思考宽谱抗生素选择
P Sadeghighazichaki1, A D Rogers1, M Elligsen2
1Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
概括
在严重烧伤患者中,早期使用抗生素是常见的,但可能导致耐药性. 这项研究发现,有针对性的抗生素选择和负的MRSA查可以改善抗菌药物管理在烧伤护理.
科学领域:
- 传染性疾病 传染性疾病
- 烧伤护理 烧伤护理
- 抗微生物药物管理委员会
背景情况:
- 感染是严重烧伤患者的常见并发症,但早期抗生素治疗指南有限.
- 广泛的抗生素经常被实证地使用,增加了抗菌素耐药性和药物毒性的风险.
研究的目的:
- 评估大烧伤患者的微生物学概况和抗生素处方模式.
- 在燃烧护理中提供基于证据的抗生素使用和抗菌药物管理信息.
主要方法:
- 对114名成年患者进行了回顾性研究,其中≥20%的总体表面积烧伤.
- 第一次阳性培养 (FPCs) 的分析,生物体识别和抗生素处方模式.
- 对抗生素敏感性数据和MRSA查结果的评估.
主要成果:
- 呼吸道和伤口部位是最常见的培养.
- 常见的生物包括对甲基西林敏感的黄金葡萄球菌,流感血球菌和Enterobacter cloacae复合体.
- 皮佩拉西林-塔扎巴克坦是最常见的经验性抗生素;美罗和西普罗素-塞法索林显示出高的隔离覆盖率.
- 负的MRSA查具有高负预测值 (~97%),支持扣留vancomycin.
结论:
- 皮佩拉西林-塔扎巴克坦在烧伤患者的早期实证使用中是有效的.
- 有针对性的抗生素替代品可以提供可比的覆盖范围,同时加强抗菌药物管理.
- 负的MRSA查可以指导科米辛的使用,减少不必要的暴露.
关键词:
抗生素管理的管理.抗生素治疗是一种抗生素治疗.广谱抗生素是一种广泛的抗生素.烧伤重症监护室的烧伤重症监护室.烧伤护理 烧伤护理第一个是积极的文化.感染的监测感染的监测.在MRSA中,MRSA可能是MRSA.更多相关视频
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